I think ultimately it (obviously) should be the doctor's call. But we've swung to such an extreme now that most people with severe chronic pain are undertreated or (more likely) untreated. I'm convinced that we're 5 years away from yet another backlash when we realize how many people with truly shitty, excruciating conditions are being forced to live in medieval medical conditions due to the current opiate hysteria.

Once again, the number of deaths from prescription opiates is dwarfed by the number of opiate deaths from illegal opiates. There's not even a comparison. And the vast majority of the opiate deaths from illegal substances are from fentanyl and related substances, which are notoriously hard to dose and/or frequently spiked and/or passed off as drugs of lesser potency. Imagine the deaths we could prevent if we (as in Europe) allowed addicts to dose themselves with supervised, clean, hygienic, pharmaceutical-grade heroin while offering them treatment to get off of them if they so desired.

Edit: I looked up current data and it looks like prescription opiates like oxycontin account for about 1/3 of opiates deaths. Maybe not quite "dwarfed" like I claimed above, but a definite minority of opiate deaths are caused by prescription narcotics. And given the current growth rate of deaths from illegal opiates, it could easily be only 10% in the next 1-2 years: https://www.cdc.gov/drugoverdose/epidemic/index.html

You need to look further than just the cause of death, prescription opioids have been the gateway to heroin for many people...

Yeah when they get cut off generally. So maybe cutting them off is putting them in a more dangerous situation then letting them have safer prescription versions.

Exactly, which is why it's such a valuable concept for opioid marketing. The line between addiction and pseudoaddiction is vague. Doctors can't judge it; nobody can judge it. Only the patient -- and the patient wants the drugs in this scenario.